The present disclosure relates generally to medical technology and in particular aspects to devices and methods for positioning a peritoneal catheter in a body of a patient to begin a medical treatment immediately after placement of the peritoneal catheter.
One use of a peritoneal catheter is during end-stage renal disease (ESRD) to instill dialysis fluid into the peritoneum into the peritoneal cavity. The peritoneal catheter must be inserted through the skin, subcutaneous fat, rectus muscle and parietal peritoneum into the peritoneal cavity. Most peritoneal catheters are equipped with a polyester synthetic cuff that is placed within the rectus muscle which encourages incorporation of the cuff into the surrounding tissue. This ingrowth requires 2 to 3 weeks to heal completely. If the site does not heal properly or heal completely, the dialysis fluid is able to leak out of the peritoneal cavity, through the rectus muscle and along the length of the peritoneal catheter. This leakage causes a variety of problems including inflammation of the tunneled area and infection by providing a means of bacterial colonization into the tunnel tract.
Another cause of improper healing is movement of the peritoneal catheter. If the polyester synthetic cuff does not properly affix the peritoneal catheter by tissue ingrowth, the cuff may slide into the cavity. Under these conditions the peritoneal catheter will be able to move, the peritoneal catheter tunnel site will be open to the dialysate solution and the cuff and catheter tunnel can become a site of bacterial colonization.
One type of catheter is available which does not require the 2 to 3 weeks of healing before the initiation of peritoneal dialysis; however this catheter has shortcomings also. This catheter has a silicone ball and flange at the site of a cuff. The ball and flange are pushed into the rectus muscle and the flange is sutured to the muscle. This effectively closes the peritoneal cavity from the tunneled catheter site. This type of catheter requires dilation of the insertion site to create adequate space for the ball and flange which creates a larger hole. In addition, suturing the flange to the muscle increases catheter placement time. This method requires additional time-consuming measures and increases the size of the hole in the muscle.
There remain needs for improved and/or alternative systems and methods for positioning a peritoneal catheter in a body of a patient to begin a medical treatment immediately after placement of the peritoneal catheter by closing the peritoneal cavity off from the tunneled catheter thus decreasing the risk of leakage and tunneling infections. The present disclosure is addressed to those needs.